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introducing our first speaker heamp;#39;s a guy who really doesnamp;#39;t need very much introduction at this conference he ran this conference for several years Julian Marsden is an emergency doc at st. Paulamp;#39;s Hospital heamp;#39;s been there for a quarter century that sounds better than 25 years he also works clinically at Mount Saint Josephamp;#39;s Hospital in Vancouver General Hospital heamp;#39;s the clinical director of the BC patient safety and quality control Council and a clinical professor in the UBC department of emergency medicine he Co leads the knowledge translation initiative there and he is the leading the clinical support tools component of the recently launched BCE M network that Jim Christensen was talking about the other day and Julian is going to enlighten us on CHF all right thanks Ryan letamp;#39;s get you some water so welcome and thanks for being here I want to say that I was I see a born at st. Paulamp;#39;s and my son was born at st. Paulamp;#